View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0960-0474	ICR Reference No: 202206-0960-004
Status: Historical Active	Previous ICR Reference No: 201903-0960-006
Agency/Subagency: SSA	Agency Tracking No:
Title: Child-Care Dropout Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/19/2023
	Date Received in OIRA: 09/01/2022
Terms of Clearance: Prior to triannual renewal, the agency will modify Supporting Statement A, questions prompts #1 and #2 to provide additional discussion related to (1) the statutory authority under which the relevant regulations impacting this information collection were promulgated; (2) the policy goal of permitting the exclusion of years from the computation period; (3) the policy result if a claimant is successfully able to demonstrate they were maintaining a child under the age of 3. The agency is encouraged to provide examples of various scenarios related to this policy and how it impacts disability determinations or payments under Title II. No later than one year prior to resubmission of this information collection for triannual renewal, the agency will evaluate, and share with OMB the reasoning and results of the evaluation, the capacity to electronically receive and process this form through eSubmit or an alternative electronic submission method.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2026	36 Months From Approved	04/30/2023
Responses	1,563	0	2,000
Time Burden (Hours)	1,407	0	167
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,563	2,000	-437
Annual Time Burden (Hours)	1,407	167	1,240
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: When we last cleared this IC in 2019, the burden was 167 hours. However, we are currently reporting a burden of 261 hours. This change stems a decrease in the number of responses from 2,000 to 1,563. In addition, we updated our burden per response from 5 minutes to 10 minutes based on current Management Information data, and our reassessment of the burden to ensure we allow time for reading the instructions, gathering the data, and answering the questions. These figures represent current Management Information data. *Note: The total burden reflected in ROCIS is 1,407, while the burden cited in #12 of the Supporting Statement is 261. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30 minute, one-way, drive burden. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

Annual Cost to Federal Government: $6,577

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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